Presentation
This case illustrates an unusual clinical presentation of bilateral intracerebral haemorrhage with supranuclear ophthalmoplegia, bradykinesia and rigidity. [ncbi.nlm.nih.gov]
Entire Body System
- Movement Disorder
Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society. [ncbi.nlm.nih.gov]
- Weakness
Bradykinesia usually transpires as the cardinal manifestation of Parkinson’s disease and relates to muscle weakness, rigid muscles, tremors, or medications’ side effects. [fwbsi.com]
Example: A 72 year old woman complains of weakness and feeling as though she is “moving underwater”. She walks slowly and is unable to catch a thrown object. Bradykinesia Related Articles APA Reference Grinnell, R. (2018). Bradykinesia. [psychcentral.com]
Patients with Parkinson's disease (PD), exhibiting muscular weakness and reduced movement speed, have been shown to be benefit from resistance training; however, little is known about the advantages of PWT for PD. [ncbi.nlm.nih.gov]
ATP13A2-RELATED JUVENILE NEURONAL CEROID LIPOFUSCINOSIS Is also known as juvenile parkinsonism-neuronal ceroid lipofuscinosis|cln12 disease Related symptoms: Ataxia Nystagmus Strabismus Muscle weakness Spasticity SOURCES: ORPHANET OMIM MENDELIAN More [mendelian.co]
- Falling
Bradykinesia predicted falls with 88.2% sensitivity and 72.1% specificity and WB time predicted falls with 76.5% sensitivity and 55.8% specificity. [n.neurology.org]
[…] grab them and together they can fall on the wall; - Second, the examiner must teach the patients how to perform the test and must explain what is going to happen if they are going to lose balance and fall. [stanfordmedicine25.stanford.edu]
Rigidity Falls and dizziness [parkinsons.org.uk]
Such balance problems in Parkinson’s disease are associated with a tendency to list or fall backward (retropulsion); in fact, a light push can cause the individual with Parkinson’s disease to continue stepping backward or to even fall down. [apdaparkinson.org]
Bradykinesia also contributes to the risk of falling in people who have Parkinson’s disease. The test used for bradykinesia is called the bradykinesia akinesia incoordination test, also known as the B.R.A.I.N. test. [healthline.com]
- Difficulty Walking
[…] match ATP13A2-RELATED JUVENILE NEURONAL CEROID LIPOFUSCINOSIS Autosomal recessive spastic paraplegia-78 is an adult-onset neurodegenerative disorder characterized predominantly by spasticity and muscle weakness of the lower limbs, resulting in gait difficulties [mendelian.co]
Ataxia / dysmetria / asynergia Ataxia is an unsteady and swaying walk, often with feet planted widely apart. People have difficulty walking a straight line with their heel touching the toe of the shoe in front (the drunk test). [neurology.uams.edu]
In old-onset hypokinesia (older than 70 years of age), typically more of a hypokinesic gait and difficulty walking and no dystonia are seen. [en.wikipedia.org]
- Rigor
[…] patients with pre-defined AE(s) Tremor Fall Parkinson s disease (worsening) Salivary hypersecretion Dyskinesia Parkinsonism Hypokinesia Movement disorder Bradykinesia Dystonia Gait abnormality Muscle rigidity Balance disorder Musculoskeletal stiffness Rigors [glosbe.com]
It is also worthy to note that in our present study, all participants were right-hand dominant and the PD-Monitor FT data from the affected limbs of patients were compared with that of the same sides from NC, making the design more rigorous than the first [translationalneurodegeneration.biomedcentral.com]
To ensure a rigorous search, the following databases were used to retrieve relevant studies: PubMed (MEDLINE), Web of Science, Scopus, IEEE Xplore and Engineering Village (Compendex and Inspec). [content.iospress.com]
Gastrointestinal
- Nausea
Ondansetron may be helpful to treat nausea; however, many more common anti-nausea medicines, including metoclopramide (Reglan®), prochlorperazine (Compazine®), or meclizine (Antivert®) may actually worsen symptoms. [endoflifecare.tripod.com]
Prolonged intake of this medication can give rise to side effects like: Nausea Mood swings Uncontrolled movements Anxiety For this reason, Levodopa is often prescribed together with carbidopa, which prevents the former from getting dissociated before [primehealthchannel.com]
“Tardive dyskinesia” is a term used for abnormal involuntary movements that begin after taking certain medications used to treat nausea or emotional problems. Tardive dyskinesia sometimes resembles chorea, dystonia, myoclonus, tics or tremor. [neurology.uams.edu]
Other potential side-effects include nightmares, orthostasis and nausea. 26-7. What surgical treatments are available for Parkinson disease? Answer 26-7. [dartmouth.edu]
Methylphenidate mainly inhibits dopamine and noradrenaline reuptake by blocking presynaptic transporters, and levodopa increases the amount of dopamine, generally improving hypokinesic gait. [13] [26] Some patients, however, have adverse reactions of nausea [en.wikipedia.org]
- Vomiting
Other findings can include liver failure, renal tubular acidosis, pancreatitis, cyclic vomiting, and hearing loss. [ncbi.nlm.nih.gov]
Orthostatic hypotension often becomes a concern in late disease, and impaired intestinal motility can lead to constipation and, sometimes, vomiting or impaired absorption. [emedicine.medscape.com]
- Diarrhea
Side effects include nausea, diarrhea, and low blood pressure. In some cases, an increase in the carbidopa dose helps to counteract this. (Domperidone is an effective alternative but is not available in the United States.) [endoflifecare.tripod.com]
Jaw & Teeth
- Dysgeusia
Maltese Diskinesja Kwalità ħażina ta ’ irqad Nervożità Mijoklonus Disturbi fl - attenzjoni Disgewżja English Dyskinesia Poor quality sleep Nervousness Myoclonus Disturbance in attention Dysgeusia Last Update: 2012-04-10 Usage Frequency: 2 Quality: Maltese [mymemory.translated.net]
- Sialorrhea
Continued Sialorrhea: Drooling. Sinemet: Trade name for the Parkinson's disease drug that is a mixture of levodopa and carbidopa. [webmd.com]
- Hypersalivation
The clinical picture includes dysarthria, postural instability with frequent falls, "cock-gait", parkinsonian signs (bradykincsia, hypomimia, extrapyramidal rigidity), bradyphrenia, hypersomnia, myoclonus, and autonomic failure (impotence, hypersalivation [library.laredo.edu]
Musculoskeletal
- Myopathy
Myoclonic epilepsy myopathy sensory ataxia (MEMSA) now describes the spectrum of disorders with epilepsy, myopathy, and ataxia without ophthalmoplegia. [ncbi.nlm.nih.gov]
MYOPATHY - Any disease of muscle. NEURALGIA - A paroxysmal pain extending along the course of one or more nerves. NEURECTOMY - Excision of part of a nerve. [aans.org]
Face, Head & Neck
- Mask-like Facies
Chorea Limb pain Retrocollis Acanthocytosis Primitive reflex Anxiety Facial grimacing Toe walking Skeletal muscle atrophy Amyotrophic lateral sclerosis Respiratory failure Sleep disturbance Gliosis Hypotension Neuronal loss in central nervous system Mask-like [mendelian.co]
Psychiatrical
- Fidgeting
In particular we should focus on: - Spontaneous movements, generally reduced in PD - Hands gestures while talking, usually reduced or absent - Eyeblink, whose spontaneous rate is reduced - Resting tremor, usually affecting one hand only - Fidgeting and [stanfordmedicine25.stanford.edu]
Neurologic
- Bradykinesia
T-tests were used to compare bradykinesia measurements between groups and a Pearson product moment correlation was performed within the PD group to examine the relationship between bradykinesia and rigidity measures. [journals.lww.com]
INTRODUCTION: Bradykinesia is usually assessed using clinical rating scales. In some circumstances, a laboratory assessment of bradykinesia using tools of higher resolution is required. [ncbi.nlm.nih.gov]
- Akinesia
We searched the literature from 1817 to 2015 for use and interpretation of the words akinesia, bradykinesia, hypokinesia, and PD. [ncbi.nlm.nih.gov]
Bradykinesia is often used synonymously with two other terms: akinesia and hypokinesia. [dict.leo.org]
Akinesia: A means absent. Akinesia means loss of some or all movements. For example, loss of blinking or normal arm swinging while walking. Bradykinesia, Hypokinesia and Akinesia have slightly different meanings. [drkharkar.com]
- Motor Symptoms
The depletion of the dopaminergic signal causes the onset of motor symptoms such as tremor, bradykinesia and rigidity. Usually, neurologists regularly monitor motor symptoms and motor fluctuations using the MDS-UPDRS part III clinical scale. [ncbi.nlm.nih.gov]
It causes motor symptoms such as resting tremor, bradykinesia and gait disorders. The disease's progressive nature requires continuous monitoring of the motor symptoms to assist the neurologist in managing medication. [computer.org]
For HC both visits were identical whereas PD patients were randomly assigned to be in their self-reported ON (i.e., when motor symptoms are well controlled) or OFF (i.e., when motor symptoms are poorly controlled) motor state52 for a given visit. [nature.com]
- Dystonia
[…] these articles: antipsychotic agents In mental disorder: Antipsychotic agents …include tremor of the limbs, bradykinesia (slowness of movement with loss of facial expression, absence of arm-swinging during walking, and a general muscular rigidity), dystonia [britannica.com]
dystonia (DYT5; 128230), caused by mutation in the GCH1 gene. [ncbi.nlm.nih.gov]
Dystonias are often accompanied by pain, e.g. stiff neck or torticollis is a form of dystonia. Other forms of dystonias are an oculogyric crisis, retrocollis, trismus, opisthotonos, or laryngospasm. [timeofcare.com]
16 Dystonia 16 (DYT16) is a very rare and newly discovered movement disorder which is characterized by early-onset progressive limb dystonia, laryngeal and oromandibular dystonia, and parkinsonism. [mendelian.co]
When dystonia first appears, the movements typically occur only with a voluntary movement of the affected body part (action dystonia). [neurology.uams.edu]
- Involuntary Movements
Term Description Dystonia. small involuntary movements characterized by muscle cramps. Dystonia is a syndrome of sustained muscle contractions, frequently causing twisting and repetitive movements, or abnormal postures. [timeofcare.com]
Dyskinesia Dyskinesia is a general term for any abnormal involuntary movement. “Tardive dyskinesia” is a term used for abnormal involuntary movements that begin after taking certain medications used to treat nausea or emotional problems. [neurology.uams.edu]
English The most common adverse reactions are dyskinesias including choreiform, dystonic and other involuntary movements. [mymemory.translated.net]
Athetosis: Abnormal involuntary movements that are slow, repetitive, and sinuous. [webmd.com]
With time, the involuntary somatic muscle movements can become nearly continual and the term chorea may be used to describe them. The term means "dance" and refers to irregular, involuntary movements of the limbs or facial muscles. [courses.washington.edu]
Workup
[…] neuroleptics (e.g., olanzapine, quetiapine), anti-emetics, calcium-channel blockers, isoniazid, serotonin-reuptake inhibitors (e.g., sertraline, fluoxetine), meperidine Disorders that mimic Parkinsonism: Catatonia, depression, spasticity, hypothyroidism Workup [endoflifecare.tripod.com]
(For more information, see Parkinson-Plus Syndromes for detailed information regarding clinical clues, workup, differential diagnosis, and treatment of atypical parkinsonisms, including multiple system atrophy, progressive supranuclear palsy, parkinsonism-dementia [emedicine.medscape.com]
Treatment
A doctor or physical therapist is an excellent resource to develop an at-home treatment plan to manage symptoms. Crucially, a person should consult their doctor before making any changes to their treatment plan, even small ones. [medicalnewstoday.com]
Prognosis
Validation and application of the pneumonia prognosis index to nursing home residents with pneumonia. Journal of the American Geriatrics Society. 1998;46(12):1538-44. 27. Naughton BJ, Mylotte JM, Tayara A. [verenso.nl]
Ünlü A, Brause R, Krakow K (2006) Handwriting analysis for diagnosis and prognosis of parkinson's disease. ISBMDA Lecture Notes in Computer Science 4345: 441–450. View Article Google Scholar 10. [journals.plos.org]
Although currently there is no cure for PD, the correct diagnosis is important not only for the treatment and prognosis, but also for clinical trials and epidemiological studies. However, practically misdiagnosis of PD is much common. [translationalneurodegeneration.biomedcentral.com]
Patients with atypical parkinsonisms typically have a worse prognosis than those with Parkinson disease, and atypical parkinsonisms respond poorly to standard anti-Parkinson disease treatments. [emedicine.medscape.com]
Etiology
Etiology The causes of parkinsonism in children are different from those in adults, and thorough examination usually requires a careful search for metabolic as well as degenerative diseases. [endoflifecare.tripod.com]
Incidence and etiology of community-acquired pneumonia in the elderly in a prospective population-based study. Scandinavian journal of infectious diseases. 2014;46(4):250-9. 9. [verenso.nl]
Parkinson disease in twins: an etiologic study. JAMA. 1999 Jan 27. 281(4):341-6. [Medline]. Polymeropoulos MH, Lavedan C, Leroy E, Ide SE, Dehejia A, Dutra A, et al. [medscape.com]
Epidemiology
Potential applications include aiding accurate early diagnosis of PD or screening populations for epidemiological studies. Earlier version presented at WCN Vienna 2013. To cite this abstract in AMA style: J.E. Alty, J. Cosgrove, M.A. Lones, S.L. [mdsabstracts.org]
Journal of clinical epidemiology. 2006;59(9):970-9. 21. Bont J, Hak E, Hoes AW, Macfarlane JT, Verheij TJ. [verenso.nl]
DISCUSSION Epidemiological studies suggest that smokers are significantly less likely than nonsmokers to develop Parkinson's Disease ( Morens et al. 1995 ). [nature.com]
[…] a good plan and follow it A good treatment center will begin More information Risk Management Plan Risk Management Plan Active substance: Drospirenone/ethinylestradiol Version number: 4.0 VI.2 Elements for a Public Summary VI.2.1 Overview of disease epidemiology [docplayer.net]
Epidemiology, pathophysiology and management". CNS Drugs. 27 (2): 97–112. doi : 10.1007/s40263-012-0012-3. ISSN 1179-1934. [en.wikipedia.org]
Pathophysiology
Moreover, altered mechanisms of sensorimotor integration may also play a role in the pathophysiology of bradykinesia. [medscape.com]
Abstract The aim of this paper is to summarise the main clinical and pathophysiological features of facial bradykinesia in Parkinson's disease (PD) and in atypical parkinsonism. [ncbi.nlm.nih.gov]
Hallett, Pathophysiology of bradykinesia in Parkinson's disease, Brain, Volume 124, Issue 11, November 2001, Pages 2131–2146 ↑ Fort Worth Brain and Spine Institiute. Available from https://www.youtube.com/watch?v=SRGCS-Al3Os ↑ Jankovic J. [physio-pedia.com]
Prevention
Noyce, Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, EC1M 6BQ, London, UK; E‐mail [email protected] Search for more papers [onlinelibrary.wiley.com]
Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom. 2. The Royal London Hospital, Barts Health NHS Trust, London, United Kingdom. [physoc.org]
The effect of the attention appears to require constant vigilance to prevent reverting to more automatic control mechanisms. 2012 Mak [2] measured and compared the walking patterns of PD patients and controls using a treadmill. [en.wikiversity.org]
Conclusions: Urinary problems in Parkinson’s patients are very frequent, which is why they must be monitored in order to improve their quality of life and prevent damage to the urinary tract, providing adequate and timely attention these problems can [mdsabstracts.org]
Prolonged intake of this medication can give rise to side effects like: Nausea Mood swings Uncontrolled movements Anxiety For this reason, Levodopa is often prescribed together with carbidopa, which prevents the former from getting dissociated before [primehealthchannel.com]